Three Exercises to Relieve Back Pain During Pregnancy

Pilates-based exercise is a simple, effective way to work movement into pregnancy and help lessen lower back pain. Here, a pilates instructor shares three of her top exercises and a video demonstration, too.

 

pregnancy woman exercisingGentle Pilates exercise is a safe and effective way to lessen low back pain during pregnancy.

Lower back pain is a common complaint for women during pregnancy. According to a 2016 study, it’s estimated that around 50% of pregnant women experience lower back pain during gestation, and for some, the pain continues postpartum.

Lower back pain during pregnancy can range from annoying to truly debilitating. For some women, it can adversely impact many daily activities—getting in the way of walking, standing, and taking care of other young (and sometimes demanding) family members.

In my Pilates practice, as well as in my own experience with pregnancy, the causes of lower back pain in pregnancy stem from two things: an exaggerated curve of the lower back (lumbar lordosis) that worsens with the weight of pregnancy, and the loosening of pelvic ligaments caused by hormonal shifts.

These are not the only possible causes of low back pain for pregnant women, but they contribute to every case I’ve worked with personally. Fortunately, targeted exercises can help with both. Doing them regularly promotes a faster recovery postpartum, as well.

Here's a look at these two causes of low back pain, both during pregnancy and beyond. If you have back pain and are expecting a child, read on to learn more about your pain and for some easy home exercises you can do to support your lower back and alleviate the pain.

Lumbar Lordosis in Pregnancy

I spoke with Micheline Cerra, a PT with 30 years of experience. Micheline is the owner of Land’s End Physical Therapy in San Francisco, and has three young sons. Over the course of her career, Micheline has worked with dozens of expectant moms. 

"During pregnancy, a woman's center of gravity shifts as the baby grows in the front of her body,” Micheline explains. "This causes exaggerated lordosis and weakens the core which both contribute to the back pain."

As the baby grows and the weight of the fetus increases, it takes up more space in the belly and moves the center of gravity forward. Some women’s bodies accommodate this shift by hyper-extending the lower spine in an exaggerated forward curve. In addition, the weight of the baby—especially in the later months—pulls on the lower back, increasing the lumbar curve.

An exaggerated lumbar curve can tighten the long muscles (back extensors) that run down either side of the spine. The tighter a muscle becomes, the more painful it can feel. Tight muscles tend to be more dehydrated, and the fascia surrounding them can become sticky—creating the painful muscular knots all of us have experienced at some point or another. During pregnancy, this tension can become chronic, and can persist postpartum.

A good way to stretch the extensor muscles and loosen the sticky fascia is bending forward, which is obviously difficult for pregnant moms. Keeping the abdominal muscles strong during pregnancy is pretty challenging, too, and these are the muscles that support the lower back the most.

Physical therapy can be really helpful. "Pregnant patients can be taught to have a stronger core, and better posture—both help with back pain,” Micheline says.

Loose Pelvic Ligaments in Pregnancy

Another common contributor to lower back pain during pregnancy is a loosening of ligaments, especially in the pelvic area. During pregnancy, a woman produces relaxin, a hormone that causes ligaments to loosen and relax. Relaxin aids the birth process—allowing the pelvis to stretch and accommodate the passage of a baby (and a baby’s head)—but during pregnancy relaxin can contribute to discomfort and pain in the pelvis and lower back.

I remember pain in my pubic bone and my sacroiiliac (SI)—joints on either side of the sacrum, in the upper glutes— worsening as my pelvic ligaments loosened and my pregnancy progressed. It felt like my joints were slipping out of place during daily movements like kicking off my shoes.

Looser ligaments can worsen pre-existing postural problems, such as exaggerated lordosis, as well. “The loosening of pelvic ligaments leads to instability, and this is also a root cause of low back pain,” says Micheline.

Pre-existing Lower Back Pain Can Worsen During Pregnancy

In a large study of pregnant women, researchers found that having a history of lower back pain is a predisposing factor for experiencing lower back pain in pregnancy. In my practice, I’ve seen that pregnancy can worsen existing symptoms of pain for my clients.

Pregnancy isn’t easy on anyone’s body, especially someone with pre-existing postural imbalances and pain. “Unfortunately, if you have a pre-disposition to lower back pain, your symptoms can become exacerbated with pregnancy," Micheline explains. "I frequently see an increase of sciatica symptoms, SI dysfunction, muscle spasms and an overall increase in poor postural positioning.” Physical therapy can really help women in this category.

Exercises to Support the Lower Back & Strengthen the Core

Here are three exercises that I relied on while pregnant, and I continue to use regularly with pregnant clients. They should be suitable for any pregnant woman since the range of motion is small and they are gentle motions. These movements shouldn't hurt. If they bother you or increase your pain, stop immediately and consult a physical therapist who can offer other exercises better suited to you.

#1. Whole Abdomen Strengthening
Sit up tall on a chair, hands clasped behind your head. Take deep breaths, and as you exhale, practice pulling your entire abdomen (including your baby) back toward your spine. Imagine your lower spine lengthening and softening as your abdominal muscles contract.

If you do not feel pain, add a small tilt backward as you exhale. Keep your spine straight, and try to feel the increased strength required of your abs to support your lower spine. The tilt can be super tiny—a little goes a long way.

#2. Standing Glute Strength
This exercise is especially good for instability and pain in the SI joints. Stand up tall, with your heels together and your toes turned out in a V shape (like first position in ballet).

As you exhale, squeeze your glutes (basically your butt cheeks) together, and feel how this helps you externally rotate your legs. At the same time, gently bring your abdomen back toward your lower back, imagining your lower back lengthening and softening.

#3. Side-Lying Glute Strength with Abdominal Support
This exercise strengthens the glute muscles along the sides of the hips—crucial for stability in walking. Lie on your side, with a pillow under your belly to support that baby. Tuck your lower leg up with the knee bent, and lengthen your upper leg long, as though you’re standing on it.

As you exhale, first practice drawing your abdominals in toward your lower back, lengthening and supporting it. When you’re ready, add a lift straight up of the top leg. Look to feel the effort right at the top of your hip, on the side.

Video Demonstration

Here’s a link to a video demonstrating these exercises:

https://youtu.be/ExfdYGmAIsk

Pregnancy is a great adventure, topped only by what comes after!

It’s a challenge for anyone’s body, especially those women pre-disposed to lower back pain. Take time for some serious self-care while you’re pregnant, including setting time aside to maintain your abdominal and glute strength.

Your lower back will thank you, and you’ll hopefully feel stronger postpartum as well.

Updated on: 11/13/20
Continue Reading:
Pregnancy and Chronic Pain: Expert Advice to Help You Thrive
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